[Diagnostic value of two immunoassays for detecting heparin/PF4 complex antibodies in heparin-induced thrombocytopenia]

Objectives: To assess the diagnostic values of latex immunoturbidimetric assay (LIA) and particle immunofiltration assay (PIFA) for heparin-induced thrombocytopenia (HIT) . Methods: Samples from 94 patients with suspected HIT from May 2016 to July 2018 in our hospital were prospectively analyzed by the two immunoassays. Their medical records and further follow-up data were also collected and analyzed by our hematologists to make the 4Ts scores and confirm the diagnosis of HIT, respectively. Performance characteristics of the two immunoassays were assessed, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) . Their post-test probabilities (PTP) were also calculated based on the 4Ts score. Results: Among 94 cases, 15 (16.0%) had a positive HIT, including 6 of 37 (16.2%) with an intermediate, and 9 of 15 (60.0%) with a high 4Ts score. PIFA operating characteristics were: sensitivity 100.0% (15/15) , specificity 51.9% (41/80) , PPV 28.3% (15/53) , NPV 100.0% (41/41) . The positive PTP in intermediate and high 4Ts score group were 28.7% and 75.7%, respectively, while negative PTP were all 0. At manufacturers' cutoffs, LIA operating characteristics were: sensitivity 66.7% (10/15) , specificity 94.9% (75/79) , PPV 71.4% (10/14) and NPV 93.8% (75/80) . The positive and negative PTP in intermediate 4Ts score group were 71.8% and 6.3%, while 95.2% and 34.4% in high 4Ts score group, respectively. Receiver operating characteristic (ROC) analysis manifested that LIA was preferable than PIFA, and combining the 2 assays together was significantly better than single test. Conclusions: 4Ts score is still an important tool for the diagnosis of HIT. Combining clinical score with heparin/PF4 antibody assay can increase the accuracy of confirming or excluding HIT. Although PIFA is inferior to LIA in the diagnostic value, its user friendliness and 100% NPV have major advantages. Combining the 2 assays together can achieve a higher diagnostic value.

Establishment of an aqueous method for extracting soybean oils assisted by adding free oil

Concern for the environment, safety and costs has promoted the development of the method for extracting soybean oil by an aqueous process. An advanced aqueous extraction of soybean oil assisted by adding free oil was established in this study, which recovered 81% of the oil from soybeans with 20.73% crude oil content and produced a de-oiled residue with 4.7% residual oil. The acid or peroxide value of the recovered oil met the Chinese national standard for first class refined oil, which was lower than that produced by solvent extraction or high temperature pressing. No wastewater was produced during the aqueous extraction of oil. The removal of the oil by the addition of oil and a small amount of water generated a residue (solids) containing all the protein, which represents 2/3 of the revenue in the soybean process. The protein-rich residue can be further processed to produce a protein isolate with high purity (e.g. > 90%) by using a higher amount of water. It can also be used as a nutritious ingredient or raw material for the production of many food products, among other applications.

[A cross-sectional study on the association between frailty and muscular performances in hospitalized elder patients with coronary artery disease]

Objective: To explore the association between frailty and muscle performances of hospitalized elder adults with coronary artery disease. Methods: A total of 122 hospitalized patients aged 65-85 years old with coronary artery disease from Department of Geriatrics and Cardiology, Peking Union Medical College Hospital between December 2017 and March 2018 were enrolled in the study. A comprehensive geriatric assessment was performed to evaluate existing comorbidity and geriatric syndromes of the patients. Frailty was assessed using the Clinical Fraity Scale. The patients were classified as frail and non-frail, according to the scale. Muscle performances were assessed using grip strength, gait speed, etc. Whole body and appendicular skeletal muscle mass was detected with bioelectrical impedance analysis in patients with reduced grip strength or slowed gait speed. Appendicular skeletal muscle index (ASMI) was calculated. Results: Among all subjects, 28 were with frailty (23.0%) and 94 were without (77.0%). The frail patients were older [(76.7±5.4) years vs. (72.2±5.6)years], had higher Charlson comorbidity index [2.0(1.0,2.75)vs. 1.0(0,2.0)], and higher proportion of malnutrition (14.29% vs. 1.06%), urinary incontinence (39.29% vs. 15.96%), using walking-aid (28.57% vs. 6.38%), and more kinds of taken drugs (8.1±3.0 vs. 6.6±2.7), than the non-frail patients. Prealbumin levels [(207.8±60.0)mg/L vs.(234.3±45.4)mg/L] were lower, and highly sensitive C-reactive protein levels [(5.89±9.57)mg/L vs.(1.89±2.49)mg/L] were higher in the frail patients than in the non-frail patients (all P<0.05). Compared with non-frail patients, the frail patients had poorer grip strength [(19.67±7)kg vs.(29.23±8.29)kg] and slower gait speed [(0.54±0.2)m/s vs.(0.91±0.22)m/s] (all P<0.001). Spearman rank correlation analyses showed that grip strength was positively correlated with the appendicular skeletal muscle mass(r=0.811), whole body skeletal muscle mass(r=0.74) and the ASMI (r=0.783), respectively. Conclusions: The incidence of frailty among hospitalized older adults with coronary artery disease is high. Poor muscle performances were common in these patients. Assessment of frailty and muscle performances can help to evaluate the overall function of older adults with cardiovascular disease in a comprehensive way.

TEM diffraction contrast images simulation of dislocations

For end-on screw dislocations and inclined dislocations within thin transmission electron microscopy (TEM) foil, TEM diffraction contrast image is largely modified around piercing point due to free surface relaxation. Based on many-beam Schaeublin-Stadelmann equations, TEM diffraction contrast images simulation of inclined dislocations within thin pure Fe TEM foil are performed and the difference between isotropic and anisotropic dislocation models are studied. Image force are superposed onto bulk elastic field of dislocation in thin foil, the elastic distortions nearby the two emerging points of a straight inclined dislocation located in an elastically isotropic/anisotropic thin foil are expressed as semianalytical solution in Fourier space, and the semianalytical image stress solutions in Fourier space are implemented into CUFOUR for studying free surface relaxation effect on TEM diffraction contrast of dislocation. Simulation results suggest that the diffraction contrast at the ends of dislocation is modified drastically by image forces, and effects of anisotropy cannot be neglected. LAY DESCRIPTION: For end-on screw dislocations and inclined dislocations within thin transmission electron microscopy (TEM) foil, TEM diffraction contrast image is largely modified around piercing point due to free surface relaxation. Based on many-beam Schaeublin-Stadelmann equations, TEM diffraction contrast images simulation of inclined dislocations within thin pure Fe TEM foil are performed and the difference between isotropic and anisotropic dislocation models are studied. Image force are superposed onto bulk elastic field of dislocation in thin foil, the elastic distortions nearby the two emerging points of a straight inclined dislocation located in an elastically isotropic/anisotropic thin foil are expressed as semianalytical solution in Fourier space, and the semianalytical image stress solutions in Fourier space are implemented into CUFOUR for studying free surface relaxation effect on TEM diffraction contrast of dislocation. Simulation results suggest that the diffraction contrast at the ends of dislocation is modified drastically by image forces, and effects of anisotropy cannot be neglected.

Multiple functions of miR-8-3p in the development and metamorphosis of the red flour beetle, Tribolium castaneum

The microRNA miR-8-3p is conserved among insects and closely involved in development and immunity, but its functions in vivo are unexplored in the red flour beetle, Tribolium castaneum. Here, we show that miR-8-3p was highly expressed in late larva and early adult stages, as determined by quantitative real-time PCR. It was enriched in the fat body and cuticle in late larval tissues and abundant in the head and cuticle in early adult tissues, indicating this microRNA plays important roles during T. castaneum development. Specific inhibition of miR-8-3p in late larvae led to metamorphosis defects in the development of wings, eyes, legs and embryo. Moreover, a series of genes related to organism development were identified as miR-8-3p targets by computational prediction and microRNA-messenger RNA interaction validation, including Wingless, Eyg, Fpps and Sema-1a. These genes were critical for the regulation of the larva-to-adult transition. Eyg, as a functional target of miR-8-3p, participates in eye development, which was further confirmed by luciferase assay and loss-of-function analyses. In brief, miR-8-3p is broadly involved in the development of wings, eyes and legs through its target genes and has extensive regulatory roles during T. castaneum development.

OlympiAD final overall survival and tolerability results: Olaparib versus chemotherapy treatment of physician's choice in patients with a germline BRCA mutation and HER2-negative metastatic breast cancer

BACKGROUND

In the OlympiAD study, olaparib was shown to improve progression-free survival compared with chemotherapy treatment of physician's choice (TPC) in patients with a germline BRCA1 and/or BRCA2 mutation (BRCAm) and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (mBC). We now report the planned final overall survival (OS) results, and describe the most common adverse events (AEs) to better understand olaparib tolerability in this population.

PATIENTS AND METHODS

OlympiAD, a Phase III, randomized, controlled, open-label study (NCT02000622), enrolled patients with a germline BRCAm and HER2-negative mBC who had received ≤2 lines of chemotherapy for mBC. Patients were randomized to olaparib tablets (300 mg bid) or predeclared TPC (capecitabine, vinorelbine, or eribulin). OS and safety were secondary end points.

RESULTS

A total of 205 patients were randomized to olaparib and 97 to TPC. At 64% data maturity, median OS was 19.3 months with olaparib versus 17.1 months with TPC (HR 0.90, 95% CI 0.66-1.23; P = 0.513); median follow-up was 25.3 and 26.3 months, respectively. HR for OS with olaparib versus TPC in prespecified subgroups were: prior chemotherapy for mBC [no (first-line setting): 0.51, 95% CI 0.29-0.90; yes (second/third-line): 1.13, 0.79-1.64]; receptor status (triple negative: 0.93, 0.62-1.43; hormone receptor positive: 0.86, 0.55-1.36); prior platinum (yes: 0.83, 0.49-1.45; no: 0.91, 0.64-1.33). Adverse events during olaparib treatment were generally low grade and manageable by supportive treatment or dose modification. There was a low rate of treatment discontinuation (4.9%), and the risk of developing anemia did not increase with extended olaparib exposure.

CONCLUSIONS

While there was no statistically significant improvement in OS with olaparib compared to TPC, there was the possibility of meaningful OS benefit among patients who had not received chemotherapy for metastatic disease. Olaparib was generally well-tolerated, with no evidence of cumulative toxicity during extended exposure. Please see the article online for additional video content.

Measurement of exclusive Υ photoproduction from protons in p Pb collisions at s NN = 5.02 TeV

The exclusive photoproduction of Υ ( nS ) meson states from protons, γ p → Υ ( nS ) p (with n = 1 , 2 , 3 ), is studied in ultraperipheral p Pb collisions at a centre-of-mass energy per nucleon pair ofs NN = 5.02 TeV . The measurement is performed using the Υ ( nS ) → μ + μ - decay mode, with data collected by the CMS experiment corresponding to an integrated luminosity of 32.6nb - 1 . Differential cross sections as functions of the Υ ( nS ) transverse momentum squared p T 2 , and rapidity y, are presented. The Υ ( 1 S ) photoproduction cross section is extracted in the rapidity range | y | < 2.2 , which corresponds to photon-proton centre-of-mass energies in the range 91 < W γ p < 826 GeV . The data are compared to theoretical predictions based on perturbative quantum chromodynamics and to previous measurements.

[Prognostic significance of CLL-IPI for Chinese patients with chronic lymphocytic leukemia]

目的

明确慢性淋巴细胞白血病国际预后指数（CLL-IPI）评分系统在中国慢性淋巴细胞白血病（CLL）患者中的预后评估价值。

方法

回顾性分析2002年1月至2017年11月诊断的215例初治CLL患者的临床资料，采用CLL-IPI评分系统进行危险分层和预后评估。

结果

①215例患者中，男143例，女72例，中位年龄60（16~85）岁。中位无治疗生存（TFS）和中位总生存（OS）时间分别为16（4~24）个月和180（145~215）个月。②按照CLL-IPI评分系统进行危险分层，低危组（60例）、中危组（50例）、高危组（45例）及极高危组（60例）的中位TFS时间分别为56、15、12及5个月，差异有统计学意义（P<0.001）。③中位随访48（1~192）个月，低危组、中危组、高危组及极高危组的中位OS时间分别为未达到和180、89、74个月，预计5年OS率分别为97.6%、83.7%、67.8%及55.2%，差异有统计学意义（P<0.001）。④多因素分析结果显示，免疫球蛋白重链可变区（IGHV）基因无突变（P=0.038）、β₂微球蛋白>3.5 mg/L（P<0.001）是影响患者TFS的独立危险因素；而TP53缺失和（或）突变（P=0.008）、IGHV基因无突变（P=0.017）、年龄>65岁（P=0.045）是影响患者OS的独立危险因素。

结论

CLL-IPI评分系统在中国初治CLL患者中具有较好的预后判断意义，可作为CLL有效的预后分层工具。

[Prognostic value of lymphocyte-to-monocyte ratio in angioimmunoblastic T cell lymphoma]

目的

探究淋巴细胞/单核细胞比值（LMR）在血管免疫母细胞性T细胞淋巴瘤（AITL）患者中的预后价值。

方法

回顾性分析2009年6月至2017年7月南京医科大学第一附属医院收治的64例初诊AITL患者资料。采用ROC曲线计算LMR临界值，并以此将患者分为高LMR和低LMR组，采用Pearson卡方检验及Fisher精确概率法进行组间比较。采用Kaplan-Meier法和Cox回归分析影响无进展生存（PFS）和总生存（OS）的预后因素。

结果

64例患者中，男39例，女25例，中位年龄63（29~89）岁。LMR临界值为3.07。中位随访33（5~103）个月，低LMR与高LMR组比较，患者的PFS时间（9对13个月，P=0.044）和OS时间（16个月对未达到，P=0.014）差异均有统计学意义。多因素分析显示低LMR是影响患者PFS（HR=0.48, 95% CI 0.26~0.92，P=0.027）和OS（HR=0.38，95% CI 0.18~0.82，P=0.013）的独立预后不良因素。亚组分析结果显示，在中高危至高危[非特指型预后指数（PIT）评分2~4分]患者中，低LMR者有更短的PFS和OS时间（P值分别为0.013、0.031），而在低危至中低危（PIT评分0~1分）患者中其差异均无统计学意义（P值分别为0.949、0.238）。

结论

可根据PIT评分及LMR的状态初步评估患者的疾病风险。低LMR提示患者具有更差的预后。

Abstract OT2-05-01: FAMILY: A randomized, multicenter, open-label, phase III trial of fulvestrant versus capecitabine as maintenance therapy after first-line combination chemotherapy in patients with hormone receptor-positive, human epidermal growth factor receptor-2 negative metastatic breast cancer

Background: Metastatic breast cancer (MBC) is incurable. Although first-line endocrine therapy is preferred to hormone receptor positive (HR+), human epidermal growth factor receptor-2 negative (HER2-) MBC, combination chemotherapy should be reserved as the initial treatment for patients with rapid clinical progression, life-threatening visceral metastases, and need for rapidly symptom control. Either prolonged chemotherapy or endocrine therapy may be used as maintenance after disease control. However, which maintenance strategy is superior in terms of delaying disease progression as well as maintaining quality of life (QOL) remains uncertain. This phase III trial aims to compare the efficacy and safety of fulvestrant or capecitabine as maintenance therapy after first-line combined chemotherapy in HR+/HER2- MBC.

Trial Design: FAMILY is a multicenter, randomized, open-label phase III trial for HR+ and HER2- MBC. Eligible participants are randomized (1:1) to receive capecitabine (2000mg/m2 twice daily x 14 days followed by 7 days off) or fulvestrant (500mg Days 0, 14, 28, then every 28 days) until disease progression, unacceptable toxicity, or patient refusal. Stratification factor for randomization is sensitivity to adjuvant hormonal therapy (disease-free interval ≤24 months vs. &gt;24 months).

Eligibility Criteria: Eligible patients must have HR+ (ER and/or PR&gt;1%, by IHC) and HER2- MBC; achieved a complete or partial response or stable disease (investigator assessed) after 4-8 cycles of first-line combination chemotherapy. Patients with central nervous system metastasis and/or prior use of endocrine therapy for advanced breast cancer are excluded.

Specific Aims: The primary endpoint is progression free survival (PFS). Secondary endpoints include overall survival, overall response rate, disease control rate, safety and QOL. A prospective translational research is also planned to assess the correlations between biomarkers and response.

Statistical Design: The planned sample size of 256 patients provides approximately 80% of power to detect a 6 months difference of PFS using a log-rank test with two-sided alpha of 0.05.

Target Accrual: Recruitment is ongoing. Up to 256 evaluable subjects will be enrolled within 24 months. (ChiCTR-IIR-17014036).

Citation Format: Yao H, Wu W, Ding L, Yu Y, Wang Y, Zeng Y, Zhao J, Li Q. FAMILY: A randomized, multicenter, open-label, phase III trial of fulvestrant versus capecitabine as maintenance therapy after first-line combination chemotherapy in patients with hormone receptor-positive, human epidermal growth factor receptor-2 negative metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-05-01.

Hydraulic conditions affect pollutant removal efficiency in distributed ditches and ponds in agricultural landscapes

Distributed ditches and ponds in agricultural landscapes can retain agricultural pollutants (such as nutrients and pesticides) like wetlands while facilitating crop field drainage. Their complex hydraulic conditions affect pollutant transport and degradation processes, but the existing lump-sum method for estimating pollutant removal treats the total area simply as one unit without considering their specific hydraulic conditions (HCs). In this paper we proposed an analytical method for evaluating pollutant removal efficiencies of distributed ditches and ponds by considering their different HCs explicitly. A realization factor (RF) was used to compare pollutant removal rates with and without considering specific HCs. Application of the method was demonstrated with a case study based on field investigations in an intensively farmed area in southeastern China. The total area of ditches and ponds accounts for 15% of drained crop fields; and the calculated RFs were 0.70-0.84% for various removal rate constants. The difference was mainly caused by the uneven distribution of ditches and ponds along different drainage paths. For pollutants with small values of removal rate constants, the calculated concentration reductions along different flow paths were proportional to their wetland sizes, making the pollutant removal as area limited. For pollutants with larger values of removal rate constant, however, the calculated pollutant removal became concentration limited when the wetland to farmland area ratio was high. Large ponds and ditches were major contributors (85-94%) of pollutant removal in the whole system, while the field ditches contributed to less than 10% of the total removal due to their small dimension and shallow water depth. The distributed nature of ditches and ponds poses some inherent limitations to their water quality functions due to variable hydraulic conditions; understanding such underlying constraints may help guide proper evaluation and conservation of the existing ditches and ponds in agricultural landscapes.

Morphological and molecular characterization of the muscle-infecting myxosporean Myxobolus xinyangensis sp. nov. from Abbottina rivularis in China

During an environmental assessment on the Huang River in Xinyang City (Henan Province, China), a novel Myxobolus species (Myxozoa: Myxobolidae) was found infecting the trunk muscle of Chinese false gudgeon Abbottina rivularis Basilewsky, 1855 (Gobioninae, Cyprinidae). Plasmodia of the new myxozoan, nominated herein as Myxobolus xinyangensis sp. nov., are round and yellowish, symmetrically and bilaterally located dorsal to the openings of the 2 opercula, and measure about 4.5 mm in diameter. The mature myxospores are orbicular in frontal view and fusiform in sutural view, with slightly tapered anterior end and rounded posterior end, and measure 9.4 ± 0.5 (8.7-10.6) µm long, 8.6 ± 0.6 (7.3-9.5) µm wide and 6.4 ± 0.3 (5.8-7.1) µm thick (mean ± SD, range). The ratio of spore length to spore width is close to 1. Two slightly unequal pyriform polar capsules, with tapering anterior ends and rounded posterior ends, measure 5.6 ± 0.67 (4.3-6.8) µm long and 3.0 ± 0.3 (2.4-3.6) µm wide, present as a figure 8 in the anterior part of spores and tightly converge at the top end of spores. Polar filament coils show 4 to 5 turns and are situated perpendicularly to the longitudinal axis of the polar capsules. No intercapsular appendix or sutural folds at the posterior end of spores were observed. The obtained partial small subunit ribosomal DNA sequence did not match any available data in GenBank and showed the highest sequence identity (93%) with 2 cyprinid trunk muscle-infecting Myxobolus species, M. pseudodispar and M. klamathellus. Phylogenetic analysis clearly showed that M. xinyangensis sp. nov. clustered within a cyprinid trunk muscle-infecting Myxobolus subclade at the basal position, but as an independent branch which was a possible reflection of its distinct myxospore morphology. This is the first record of infection of Myxobolus species in the trunk muscle of Abbotina fish.

[Prevalence of diabetes and its associated factors in Blang ethnic adults]

Objective: To investigate the prevalence and associated risk factors of diabetes and prediabetes in Blang ethnic adults in Menghai county. Methods: A cross-sectional survey including 3 365 Blang ethnic adults (aged 18 and above from 5 administrative villages) was conducted from February 2017 to March 2017 in Menghai county. A questionnaire, physical examination, and blood assays were included in the survey. Finally, a total of 3 237 adults with complete data were selected into this analysis. Results: The standardized prevalence of diabetes and prediabetes in Blang ethnic adults were estimated based on the sixth national census in 2010. According to the 1999 WHO criteria, the overall standardized prevalence of diabetes and prediabetes were 8.5% (men: 10.2%, women: 6.8%) and 16.1% (men: 18.0%, women: 14.1%), in which the standardized prevalence of newly diagnosed diabetes among the total population was 7.3% (men: 8.7%, women: 5.8%). Multivariable multinominal logistic regression analyses showed that age, hypertension, hypertriglyceridemia, and central obesity were significantly positively associated with both diabetes and prediabetes, with the corresponding odds ratios of 1.74 and 1.37, 2.39 and 2.02, 2.30 and 1.34, 2.55 and 1.73, respectively. Conclusion: The prevalence of diabetes is relatively high in Blang ethnic adults in Menghai county. Improving knowledge of diabetes among the local population is one of key steps in the prevention of diabetes.

Observation of Medium-Induced Modifications of Jet Fragmentation in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV Using Isolated Photon-Tagged Jets

Measurements of fragmentation functions for jets associated with an isolated photon are presented for the first time in pp and Pb-Pb collisions. The analysis uses data collected with the CMS detector at the CERN LHC at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Fragmentation functions are obtained for jets with p_{T}^{jet}>30  GeV/c in events containing an isolated photon with p_{T}^{γ}>60  GeV/c, using charged tracks with transverse momentum p_{T}^{trk}>1  GeV/c in a cone around the jet axis. The association with an isolated photon constrains the initial p_{T} and azimuthal angle of the parton whose shower produced the jet. For central Pb-Pb collisions, modifications of the jet fragmentation functions are observed when compared to those measured in pp collisions, while no significant differences are found in the 50% most peripheral collisions. Jets in central Pb-Pb events show an excess (depletion) of low (high) p_{T} particles, with a transition around 3  GeV/c. This measurement shows for the first time the in-medium shower modifications of partons (quark dominated) with well-defined initial kinematics. It constitutes a new well-controlled reference for testing theoretical models of the parton passage through the quark-gluon plasma.

Value of BRAF V600E in High-Risk Thyroid Nodules with Benign Cytology Results

BACKGROUND AND PURPOSE

Limitations of ultrasound-guided fine-needle aspiration include nondiagnostic, indeterminate cytology and false-negative results. The BRAF V600E mutation is a specific biomarker for papillary thyroid carcinoma. This study aimed to investigate the additional diagnostic role of the BRAF V600E mutation in high-risk thyroid nodules with benign cytology results.

MATERIALS AND METHODS

A total of 787 high-risk nodules in 720 patients underwent ultrasound-fine-needle aspiration. A subsequent BRAF V600E mutation test was performed on thyroid nodules with benign cytology. Final pathology confirmed thyroid nodules with benign cytology that were positive for the BRAF V600E mutation. Ultrasound was performed on thyroid nodules with benign cytology results that were negative for the BRAF V600E mutation. Fine-needle aspiration was repeated on thyroid nodules with enlarged size or changed ultrasound features.

RESULTS

Among the 787 nodules, 292 thyroid nodules had benign cytology results with 256 nodules negative for the BRAF V600E mutation and 36 nodules positive for the BRAF V600E mutation. Thirty-one nodules positive for the BRAF V600E mutation were confirmed malignant, and 5 nodules were confirmed benign by pathology. Fine-needle aspiration was repeated on 11 enlarged thyroid nodules with benign cytology findings that were negative for the BRAF V600E mutation. The results of repeat fine-needle aspiration were 4 benign nodules, 2 follicular neoplasms or suspected follicular neoplasms, 3 suspected malignancies, and 2 malignant nodules. Among the 36 thyroid nodules positive for the BRAF V600E mutation, 25 (69.4%) had ≥2 suspicious ultrasound features and 11 (30.6%) nodules had 1 suspicious ultrasound feature.

CONCLUSIONS

The BRAF V600E mutation test can detect papillary thyroid carcinomas that might be missed by fine-needle aspiration. We recommend that fine-needle aspiration be routinely accompanied by the BRAF V600E mutation test in high-risk thyroid nodules with ≥2 suspicious ultrasound features.

Measurement of differential cross sections for Z boson production in association with jets in proton-proton collisions at s = 13 TeV

The production of a Z boson, decaying to two charged leptons, in association with jets in proton-proton collisions at a centre-of-mass energy of 13TeV is measured. Data recorded with the CMS detector at the LHC are used that correspond to an integrated luminosity of 2.19fb -1 . The cross section is measured as a function of the jet multiplicity and its dependence on the transverse momentum of the Z boson, the jet kinematic variables (transverse momentum and rapidity), the scalar sum of the jet momenta, which quantifies the hadronic activity, and the balance in transverse momentum between the reconstructed jet recoil and the Z boson. The measurements are compared with predictions from four different calculations. The first two merge matrix elements with different parton multiplicities in the final state and parton showering, one of which includes one-loop corrections. The third is a fixed-order calculation with next-to-next-to-leading order accuracy for the process with a Z boson and one parton in the final state. The fourth combines the fully differential next-to-next-to-leading order calculation of the process with no parton in the final state with next-to-next-to-leading logarithm resummation and parton showering.

Expression analysis of multifunctional RNA-binding protein hnRNP K during development of mammalian testis

Heterogeneous nuclear ribonucleoprotein K (hnRNP K), is a multifunctional protein that participates in a variety of regulatory processes of signal transduction and gene expression. To further characterize the significance of hnRNP K in different male germ cells, we investigated the expression profiles of hnRNP K at different developmental stages in pig and rat testes, and conducted a comparative analysis of expression patterns between these two species. In porcine testis development, both the mRNA and protein level of hnRNP K were down-regulated from 3 months to 8 months. However, the expression level of hnRNP K was abundant across the embryonic period in rats, and decreased gradually from 0 day post partum (dpp) to 14 dpp, then increased with the highest level presenting at 90 dpp. Immunolocalization analysis further confirmed the differential expression and localization of hnRNP K protein during testis development in pigs and rats. The results showed that hnRNP K was widely distributed in gonocytes, spermatogonia, sertoli cells and Leydig cells. The dynamic expression profile of hnRNP K may imply its crucial and potential roles in the development of the testis, which will provide a theoretical basis for the future study of molecular mechanism regulation of spermatogenesis.

[Analysis of the influencing factors of recombinant human growth hormone effect in the children with Turner syndrome]

Objective: To analyze the clinical data, karyotype, growth hormone receptor (GHR) exon 3 polymorphism, etc. in Turner syndrome before and after recombinant human growth hormone (rhGH) treatment, and thereby to understand the related factors influencing the rhGH curative effect in children with Turner syndrome. Methods: This was a retrospective study of 31 cases with Turner syndrome who were treated with growth hormone for more than 1 year in the pediatric outpatient department of Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2010 to January 2017. The GHR Exon3 polymorphism was detected by PCR assay, Turner syndrome children were divided according to GHR exon3 genotype for homozygous for the full-length GHR isoform (fl/fl-GHR)and carriers of one or two copies of the GHR exon3 allele(fl/d3-GHR;d3/d3-GHR).According to the karyotype, the children were divided into 45,X karyotype group and other karyotype group. The height standard deviation (Ht-SDS) and growth velocity (GV) as indicators to measure rhGH treatment efficacy, the data were analyzed by the SPSS12.0 software (t test, one-way ANOVA and multiple linear regression analysis). Results: (1) The mean age at diagnosis of 31 cases was (12.2±2.9) years, the bone age was (8.9±2.4) years, the height was (126.2±10.5) cm and the Ht-SDS was (-3.5±1.3) SDS. The karyotype was 45,X in 14 patients, 17 cases had other karyotypes. Thirteen cases were of (fl/fl-GHR) (42%), 14 cases of fl/d3-GHR (45%) and 4 cases of d3/d3-GHR(13%).Among the 31 cases, the main reason for 5 patients' hospitalization was no secondary sexual characteristics, another 26 cases had short stature (accounting for 81%).(2) After Growth hormone treatment, growth rate (cm/year)(7.3±1.4, 7.0±3.0, 7.0±1.3) and Ht-SDS (-2.8±1.2, -2.5±0.9, -2.2±0.8) were significantly higher than the pre-treatment levels (2.9±0.9, -3.5±1.3), the difference was statistically significant (F=54.12, 4.43, P<0.05) ; the third year Ht-SDS(-2.2±0.8)higher than the first year Ht-SDS(-2.8±1.2), the difference was statistically significant (t=-2.3, P<0.05) .(3)Before rhGH treatment, the height of 45,X karyotype group was significantly lower than that of other karyotypes ((122.1±9.1) cm vs. (129.9±10.3) cm, t=-2.2, P<0.05)). Before and after rhGH treatment, there was no significant difference in growth rate (cm/year) and Ht-SDS, between 45, X karyotype group and other karyotype group, but with the prolongation of treatment time, the Ht-SDS of other karyotype groups had an improvement trend compared with the 45,X karyotype groups. (4) After short-term and long-term treatment with rhGH, there were no significant differences in GV, Ht-SDS between patients with different genotypes (P>0.05). (5) Multivariate linear regression analysis showed that ΔHt-SDS was negatively correlated with the age at initial treatment(partial regression coefficient=-0.098, P <0.05), and positively correlated with GV before treatment(partial regression coefficient=0.202, P<0.05). Conclusions: In Turner's syndrome children, the earlier the rhGH treatment started, the faster the growth rate before treatment and the longer treatment duration, the better effect of rhGH treatment was obtained. Before rhGH treatment, the height of 45,X karyotype group was significantly lower than that of other karyotypes. Before and after rhGH treatment, there was no significant difference in growth rate (cm/year) and Ht-SDS, but with the prolongation of treatment time, the Ht-SDS of other karyotype groups had an improvement trend compared with the 45,X karyotype groups. GHR exon 3 polymorphism did not significantly affect the efficacy of rhGH in Turner syndrome children, but large-scale long-term studies are still needed.

Measurement of the top quark mass with lepton+jets final states using p p collisions at s = 13 TeV

The mass of the top quark is measured using a sample of t t ¯ events collected by the CMS detector using proton-proton collisions ats = 13 TeV at the CERN LHC. Events are selected with one isolated muon or electron and at least four jets from data corresponding to an integrated luminosity of 35.9fb - 1 . For each event the mass is reconstructed from a kinematic fit of the decay products to a t t ¯ hypothesis. Using the ideogram method, the top quark mass is determined simultaneously with an overall jet energy scale factor (JSF), constrained by the mass of the W boson in q q ¯ ' decays. The measurement is calibrated on samples simulated at next-to-leading order matched to a leading-order parton shower. The top quark mass is found to be 172.25 ± 0.08 (stat+JSF) ± 0.62 (syst) GeV . The dependence of this result on the kinematic properties of the event is studied and compared to predictions of different models of t t ¯ production, and no indications of a bias in the measurements are observed.

Imaging divertor strike point splitting in RMP ELM suppression experiments in the DIII-D tokamak

Fast visible imaging of the lower divertor from above is used to study the structure and dynamics of lobes induced by resonant magnetic perturbations (RMPs) in Edge-Localized Mode (ELM) suppression experiments in DIII-D. The best compromise between the amount of light and sharp imaging was obtained using emission at 601 nm from Fulcher band molecular deuterium. Multiple spatially resolved peaks in the D₂ emission, taken as a proxy for the particle flux, are readily resolved during RMPs, in contrast to the heat flux measured by infrared cameras, which shows little spatial structure in ITER-like conditions. The 25 mm objective lens provides high spatial resolution (2-4 mm/pixel) from the centerpost to the outer shelf over 40° toroidally that overlaps the field of view of the IRTV that measures the divertor heat flux, allowing direct comparison in non-axisymmetric discharges. The image is coupled to a Phantom 7.3 camera using a Schott wound fiber bundle, providing high temporal resolution that allows the lobe dynamics to be resolved between ELMs and across ELM suppression onset. These measurements are used to study the heat and particle flux in 3D magnetic fields and to validate models for the plasma response to RMPs.

Search for new physics in dijet angular distributions using proton-proton collisions at s = 13 TeV and constraints on dark matter and other models

A search is presented for physics beyond the standard model, based on measurements of dijet angular distributions in proton-proton collisions ats = 13 TeV . The data collected with the CMS detector at the LHC correspond to an integrated luminosity of 35.9fb - 1 . The observed distributions, corrected to particle level, are found to be in agreement with predictions from perturbative quantum chromodynamics that include electroweak corrections. Constraints are placed on models containing quark contact interactions, extra spatial dimensions, quantum black holes, or dark matter, using the detector-level distributions. In a benchmark model where only left-handed quarks participate, contact interactions are excluded at the 95% confidence level up to a scale of 12.8 or 17.5TeV, for destructive or constructive interference, respectively. The most stringent lower limits to date are set on the ultraviolet cutoff in the Arkani-Hamed-Dimopoulos-Dvali model of extra dimensions. In the Giudice-Rattazzi-Wells convention, the cutoff scale is excluded up to 10.1TeV. The production of quantum black holes is excluded for masses below 5.9 and 8.2TeV, depending on the model. For the first time, lower limits between 2.0 and 4.6TeVare set on the mass of a dark matter mediator for (axial-)vector mediators, for the universal quark couplingg q = 1.0 .

Feasibility of yoga as a complementary therapy for patients with type 2 diabetes: The Healthy Active and in Control (HA1C) study

OBJECTIVES

This study:Healthy Active and in Control (HA1C), examined the feasibility and acceptability of yoga as a complementary therapy for adults with Type-2 Diabetes (T2DM).

DESIGN

A 2-arm randomized clinical trial comparing Iyengar yoga with a supervised walking program.

SETTING

Hospital based gym-type facility and conference rooms.

INTERVENTIONS

Participants were randomized to a 12-week program of either; (1) a twice weekly Iyengar yoga, or (2) a twice-weekly program of standard exercise (SE).

MAIN OUTCOME MEASURES

Primary outcomes assessed feasibility and acceptability, including enrollment rates, attendance, study completion, and participant satisfaction. Secondary outcomes included HbA1c, physical activity, and measures of diabetes-related emotional distress, self-care and quality of life (QOL). Assessments were conducted at baseline, end of treatment, 6-months and 9-months post-enrollment.

RESULTS

Of 175 adults screened for eligibility, 48 (30 women, 18 men) were eligible and enrolled. The most common reasons for ineligibility were orthopedic restrictions, HbA1c levels <6.5 and BMI > 42. Session attendance was high (82% of sessions attended), as was follow-up completion rates (92%). Program satisfaction rated on a 5-point scale, was high among both Yoga (M = 4.63, SD = 0.57) and SE (M = 4.77, SD = 0.52) participants. Overall 44 adverse events (26 Yoga, 18 SE) were reported. Of these, six were deemed "possibly related" (e.g., neck strain, back pain), and 1 "probably related" (ankle pain after treadmill) to the study. Yoga produced significant reductions in HbA1c. Median HbA1c at 6 months was 1.25 units lower for Yoga compared to SE (95% CI: -2.54 -0.04). Greater improvements in diabetes self-care, quality of life, and emotional distress were seen among Yoga participants than among SE participants. Increases in mindfulness were seen in Yoga but not in SE.

CONCLUSIONS

The yoga intervention was highly feasible and acceptable, and produced improvements in blood glucose and psychosocial measures of diabetes management.

Measurement of the Z / γ ∗ → τ τ cross section in pp collisions at s = 13 TeV and validation of τ lepton analysis techniques

A measurement is presented of the Z / γ ∗ → τ τ cross section in pp collisions ats = 13 TeV , using data recorded by the CMS experiment at the LHC, corresponding to an integrated luminosity of 2.3 fb - 1 . The product of the inclusive cross section and branching fraction is measured to be σ ( pp → Z / γ ∗ +X ) B ( Z / γ ∗ → τ τ ) = 1848 ± 12 ( stat ) ± 67 (syst \,+\,lumi) pb , in agreement with the standard model expectation, computed at next-to-next-to-leading order accuracy in perturbative quantum chromodynamics. The measurement is used to validate new analysis techniques relevant for future measurements of τ lepton production. The measurement also provides the reconstruction efficiency and energy scale for τ decays to hadrons+ ν τ final states, determined with respective relative uncertainties of 2.2 and 0.9%.

Search for third-generation scalar leptoquarks decaying to a top quark and a τ lepton at s = 13 Te

A search for pair production of heavy scalar leptoquarks (LQs), each decaying into a top quark and a τ lepton, is presented. The search considers final states with an electron or a muon, one or two τ leptons that decayed to hadrons, and additional jets. The data were collected in 2016 in proton-proton collisions ats = 13 Te with the CMS detector at the LHC, and correspond to an integrated luminosity of 35.9fb - 1 . No evidence for pair production of LQs is found. Assuming a branching fraction of unity for the decay LQ → t τ , upper limits on the production cross section are set as a function of LQ mass, excluding masses below 900Ge at 95% confidence level. These results provide the most stringent limits to date on the production of scalar LQs that decay to a top quark and a τ lepton.

[Cephalic artery peak velocity variation during passive leg raising can predict fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing]

Objective: To explore whether cephalic artery peak velocity variation during passive leg raising (ΔVpeak(CA)-PLR) could effectively predict fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing. Methods: Total of 38 patients on mechanical ventilation with spontaneous breathing admitted to the Fourth Departments of Intensive Care Unit (ICU) of Fujian Provincial Hospital from January to December in 2017 were enrolled.The patients were diagnosed with severe sepsis or sepsis shock.The peak velocity in cephalic artery (Vpeak(CA)) during PLR was measured by bedside portable ultrasonic, and then ΔVpeak(CA)-PLR was calculated.All patients received volume expansion (VE) test and the changes of stroke volume during VE test (ΔSV-VE) were measured.Patients were classified as responsive group or non-responsive group according to the ΔSV-VE increased ≥15% or not after VE test.Furthermore, the sensitivity and specificity of ΔVpeak(CA)-PLR for predicting fluid responsiveness were evaluated by receiver operating characteristic (ROC) curve.The comparisons between groups were performed with Student's unpaired two-tailed t test, and Pearson's test was used for the correlation analysis. Results: Among the patients, 22 cases responded to VE test and the rest 16 cases did not.There were no significantly differences in age, gender, body mass index, infection site, sepsis-related organ failure assessment score, acute physiology and chronic health evaluation Ⅱ score, ventilator parameters and dose of vasoactive agent between the two groups.The ΔVpeak(CA)-PLR in responsive group was markedly higher than that in non-responsive group (15.7%±4.2% vs 6.9%±4.3%, t=6.240, P<0.05), and the ΔVpeak(CA)-PLR in the responsive group was positively related to the ΔSV-VE (r=0.723, P<0.05). Furthermore, the area of ΔVpeak(CA)-PLR under ROC curve was 0.912.The sensitivity and specificity of ΔVpeak(CA)-PLR≥12.2% to predict fluid responsiveness in the patients with sepsis were 81.8% and 87.5%, respectively. Conclusion: ΔVpeak(CA)-PLR measured by bedside portable ultrasonic can predict the fluid responsiveness in mechanically ventilated severe sepsis patients with spontaneous breathing, and it can be used to guide further fluid resuscitation.

Myocardial reperfusion with tirofiban injection via aspiration catheter : Efficacy and safety in STEMI patients with large thrombus burden

BACKGROUND

There is no consensus on the use of thrombus aspiration (TA) in primary percutaneous coronary intervention (PPCI), and few studies have focused on the performance of tirofiban via TA catheter after PPCI. Our study investigated the clinical outcome of tirofiban injection through TA in acute ST-segment elevation myocardial infarction (STEMI) patients with large thrombus burden undergoing PPCI treatment.

PATIENTS AND METHODS

The study comprised 122 STEMI patients who underwent TA during PPCI. Participants were randomly divided into two groups. Group A received intravenous tirofiban injection and tirofiban injection via a TA catheter to the infarcted coronary artery after aspiration (n = 61). Group B received intravenous tirofiban injection only (n = 61). Baseline clinical information and follow-up data were collected for both groups. Coronary angiography, electrocardiography, and echocardiography findings as well as major adverse cardiovascular events (MACE) were recorded.

RESULTS

There were significant differences in postprocedural Thrombolysis in Myocardial Infarction (TIMI) grade 2 and 3 flow between the two groups (p = 0.021, p = 0.006, respectively). The incidence of slow-flow in group A was significantly lower than that of group B (p = 0.011). An increased incidence of no ST-segment resolution was observed in group B (p = 0.011). There were fewer major adverse cardiovascular events in group A than in group B, but the difference was not statistically significant.

CONCLUSION

Selective tirofiban injection via TA catheter during PPCI may improve myocardial reperfusion in STEMI patients with large thrombus burden.

[Individual difference of coronal bowing of femur and its influence on the lower limbs alignment after the total knee arthroplasty]

Objective: To disclose the correlation between the femur bowing angle(FBA) and vulgas correction angle(VCA), anlysys its influence on the total knee arthroplasty and the lower limbs alignment. Methods: From Janurary 2013 to December 2015, 699 patients who had received total knee arthroplasty(TKA)were collected in the Department of Joint Surgery, China-Japan Friendship. The FBA, VCA, offset of the proximal femur, the lengh of the femur, the neck shaft angle of the femur of the eligible cases from the long leg X-ray were measured.All the data were analysed for the following steps: the FBA's mean value and characteristics of distributation of all the cases; the VCA's mean value and characteristics of distributation of all the cases; correlations between the VCA and the other parameters; divide all the cases into four groups based on the value of FBA : group A(FBA<-3°, 29), group B(-3°≤FBA≤0°, 255), group C(0°<FBA≤3°, 480), group D(FBA>3°, 236)and then plan to cut the distal femur with 5° and 6°, respectively. The percent of ideal alignmental outcome's percentage of every group were compared. Results: The mean Value of the FBA is -7.1--12.1(1.4±2.4)°; the mean Value of the VCA is 2.5--11.9(6.5±1.3)°. The correlation index between VCA and FBA, the neck shaft angle of the femur , offset of the hip joint, the lengh of the femur is 0.72, -0.26, 0.45 and -0.08, perspectively. The theoretical ideal alignment percentage of the 5 degree-valgus-bone cut and 6 degree-valgus-bone cut in every group is group A: 89.7% and 66.5%; group B: 93.7% and 95.7%; group C: 71.9% and 94.6%; group D: 21.2% and 50.8%, respectively. Conclusion: The cases whose femur bowing angles are outliers are common in daily medical practice, so the vulgas correction angles need be ajusted for its significant correlation with FBA. 5 degree-valgus-bone cut or 6 degree-valgus-bone cut could not get the ideal alignment some times.

Search for Physics Beyond the Standard Model in Events with High-Momentum Higgs Bosons and Missing Transverse Momentum in Proton-Proton Collisions at 13 TeV

A search for physics beyond the standard model in events with one or more high-momentum Higgs bosons, H, decaying to pairs of b quarks in association with missing transverse momentum is presented. The data, corresponding to an integrated luminosity of 35.9  fb^{-1}, were collected with the CMS detector at the LHC in proton-proton collisions at the center-of-mass energy sqrt[s]=13  TeV. The analysis utilizes a new b quark tagging technique based on jet substructure to identify jets from H→bb[over ¯]. Events are categorized by the multiplicity of H-tagged jets, jet mass, and the missing transverse momentum. No significant deviation from standard model expectations is observed. In the context of supersymmetry (SUSY), limits on the cross sections of pair-produced gluinos are set, assuming that gluinos decay to quark pairs, H (or Z), and the lightest SUSY particle, LSP, through an intermediate next-to-lightest SUSY particle, NLSP. With large mass splitting between the NLSP and LSP, and 100% NLSP branching fraction to H, the lower limit on the gluino mass is found to be 2010 GeV.

Search for Heavy Neutral Leptons in Events with Three Charged Leptons in Proton-Proton Collisions at sqrt[s]=13 TeV

A search for a heavy neutral lepton N of Majorana nature decaying into a W boson and a charged lepton is performed using the CMS detector at the LHC. The targeted signature consists of three prompt charged leptons in any flavor combination of electrons and muons. The data were collected in proton-proton collisions at a center-of-mass energy of 13 TeV, with an integrated luminosity of 35.9  fb^{-1}. The search is performed in the N mass range between 1 GeV and 1.2 TeV. The data are found to be consistent with the expected standard model background. Upper limits are set on the values of |V_{eN}|^{2} and |V_{μN}|^{2}, where V_{ℓN} is the matrix element describing the mixing of N with the standard model neutrino of flavor ℓ. These are the first direct limits for N masses above 500 GeV and the first limits obtained at a hadron collider for N masses below 40 GeV.